PSI - Issue 40

V. Mironov et al. / Procedia Structural Integrity 40 (2022) 296–306

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V. Mironov at al. / Structural Integrity Procedia 00 (2022) 000 – 000

1. Introduction A high-precision real-time diagnosis of the heart rhythm deregulations during surgery performance has been reported to be urgently needed for the prophylaxis of life-threatening cardiovascular system conditions before, during, and after the heart and vessel surgical interventions. RCG has been shown to be quite a precise and adequate method since the overwhelming majority of urgent events are triggered by the heart rhythm deregulation. Also, high resolution RCG is more precise than standard monitoring techniques during open heart CABGs myocardial revascularization. Besides ECG, ECHO-CG, blood pressure registration, ongoing RCG may be seen immediately on the screen in the real-time mode. The RCG has been shown to have a high resolution in a discretization of 1000±3 Hz frequency signals. There are at least 3 heart rhythm modulating factors, namely: the activity of sympathetic and parasympathetic autonomic system compartments, as well as humoral and metabolic extracellular environment influence on the transmembrane ion flow of pacemaker cells of sinoatrial heart node. The content of ions is constantly changing and it modifies the speed of spreading of active potentials. Therefore, the extracellular environment should be considered as the third factor of the HRV regulation (Hainsworth (1995), Nozdrachev (1991), Dudel (1985), Kassil (1981), Zhemaytite at al. (1985), Zhemaytite at al. (1982)). The CAP-RC-02-Micor APC allows simultaneous ECG and RCG registration in a real-time mode for ensuring the fast analyses of the HRV in every 300 RR-intervals both in Time-Domain and Frequency-Domain Mironov (2002). The aim of the study was the evaluation of RCG with HRV analyses for real-time mode of current cardiovascular status assessment in subjects with coronary artery disease (CAD) during myocardial revascularization by the CABGS.

Nomenclature RCG

high-resolution rhythmocardiography CABGS coronary artery bypass graft surgery

HRV heart rate variability CAD coronary artery disease CHF chronic heart failure ACN autonomic cardioneuropathy APC

apparatus-program computer author complex

AF BP

atrial flutter blood pressure

ECG CPS CVP

electrocardiography cardio plegic solution central venous pressure

SN

sinoatrial node

2. Methods In a cross-sectional study, 123 pts were investigated by standard cardiological functional and laboratory methods and high-resolution RCG with the evaluation of the HRV-indices. Before and after CABGS, pts were examined in a recumbent position and in 4 stimulant tests, while during shunting procedure, RCG was performed in monitor mode without stimulation. A CAP-RC-01-Micor original apparatus and software computer complex (APC) (Certificate FS0022б2005/2447 -06) with 1000±3Hz frequency ECG signal recording was applied before, during (in monitor mode), and after surgery. Average RCG-indices were calculated, namely mean of all the RR-intervals, standard deviation of all the RR (SDNN), average quadratic indices parasympathetic (σ s ), sympathetic index of HRVV- waves (σ m ), and average quadratic indices of the humoral-metabolic influence on autonomic regulation (σ l ). Also spectral analysis was performed with the Fast Fourier Transformation and spectral windows for selecting three shares of regulative